Long COVID is ’emerging public health crisis’

While people who have COVID-19 can be contagious for as long as 10 days, the symptoms for some are lasting months or even years and that is poised to be a big burden on Saskatchewan.

“I think this is going to be the emerging public health crisis after COVID itself that is off most people’s radar right now, except for those unfortunate people who’ve had it,” said Dr. Gary Groot.

Groot is both a medical doctor and has a doctorate. He’s a professor at the University of Saskatchewan and medical director for clinical quality improvement at the Saskatchewan Health Authority (SHA).

Right now, Groot said there isn’t any consistent definition of what is considered long COVID, also known as post-COVID syndrome.

According to Groot, there are two groupings of people under the long COVID umbrella: The first comprises people who were very sick with COVID and often had to be treated in hospital. Many of those people continue to have heart or respiratory challenges that need to be treated by specialists after they leave hospital.

“They have ongoing rehab needs. Fortunately, they’re the smallest percentage of people who have ongoing symptoms,” said Groot.

The other group, according to Groot, is people who are struggling with less-severe things like brain fog, fatigue, malaise, anxiety and depression, which can start months after infection.

“(They have) those kinds of symptoms which prevent them from working but don’t necessarily require them being in hospital,” said Groot.

There are a lot of unknowns when it comes to long COVID, including how prevalent the problem is. Groot said the literature says anywhere from 10 to 90 per cent of people who’ve had COVID could have longer-term symptoms. Groot thinks it would be somewhere in the middle.

“I think the number of people who have some degree of ongoing symptomatology after they’ve had COVID is probably in the 20 to 50 per cent range, which is a large number,” said Groot.

The number would be larger if more people contract COVID in a province with no public health measures and no reliable case numbers.

Modelling Groot’s team did last year suggested about 5,000 people would need specialist care for long COVID, about 7,000 would need intermediate care, and about 50,000 people would be able to manage from home. But those numbers were developed before the fourth, fifth and sixth waves.

“I think those numbers are going to be higher now,” said Groot.

Some people with long COVID start to get better after three months, said Groot, but for others it can take a year. And Groot said there are still others who will get better and then relapse.

The stresses of long COVID will be a burden on Saskatchewan’s health-care system but also its economy, said Groot. He pointed to people needing health-care services, health-care workers getting long COVID and not being able to work, and people in general with the syndrome not being able to work.

Given that COVID isn’t over and hasn’t gone away, Groot said the problem isn’t over.

“My guess — just from everything I know just about following closely with COVID — is that we’re going to be seeing future waves, so we’re not done with this. And those waves will also be associated with people that have symptoms that go on,” said Groot.

Groot believes there is work being done within the government and the SHA to address long COVID. A group he headed created a report with some recommendations last year, and Groot said it’s his understanding that those are being looked at for implementation.

The recommendations include developing a pathway to support the care of people with long COVID, and creating educational materials for doctors and patients.

“Given that there are so many unknowns about long COVID and how to manage it, there’s a lot of information that needs to be communicated out to physicians, and along the same lines, similarly for patients,” said Groot.

The last recommendation is to create a registry of patients with long COVID to learn from them and their experiences.

Groot is hopeful there will be movement on these recommendations this calendar year, as he said the need for these things is imminent.